Summary

Furthermore, vertical stabilization must be considered, and the acromioclavicular ligament complex repair technique is primarily concerned with horizontal stabilization.

Abstract

Background

The current concept procedures in the acute acromioclavicular joint dislocation should be divided into two structures restoration: those that provide coracoclavicular stabilization, which affects the primary healing of the coracoclavicular ligaments by vertically stabilizing the clavicle and coracoid in their anatomical positions, and those that attempt to repair the superior acromioclavicular ligaments complex (ACLC), which controls both horizontal and rotational stabilization.

Objectives
This technique reconstructs the coracoclavicular and acromioclavicular ligaments under image intensifier guidance will achieve bidirectional (vertical and horizontal) and rotational stability.

Study Design & Methods
The surgery is performed in a 70° tilt in a beach chair position. The first tunnel was drilled 4 mm from the articular part of the distal clavicle to the anterior using a 2.5 mm drilling. The second tunnel was drilled from the articular part of the distal clavicle to the anterior part of the clavicle by a 2.5 mm drilling from the posterior to the anterior direction. Three fiber wire 2-0 sutures (FiberWire®, Arthrex) were shuttled with PDS at the lateral horizontal tunnel from anterior to posterior direction. Each pair of suture limbs was retrograde sutured to the ACLC by 1 cm. We tied three knots for the lateral row of the suture bridge after suturing each pair of sutures in the anterior, superior, and posterior parts of the ACLC. Three suture limbs were prepared for each suture limb. At the medial horizontal tunnel, the anterior section of the three suture limbs was shuttled with double loop PDS from the anterior to the posterior. The posterior part of the three suture limbs was shuttled with double loop PDS from the posterior to the anterior at the same tunnel. The medial row was created by tying three knots over the clavicle.

Results

The arthroscopically assisted CC stabilization and ACLC with a combination of two synergistic contributions is a new arthroscopy technique. This technique is designed to restore vertical, horizontal, and rotational instability.

Conclusions

This specific configuration technique improves other surgical techniques in regard to ACLC healing, which is typically associated with horizontal and rotational stability. The failure of the AC joint stability was reduced by all the AC and CC stabilization.